Grief After Loss: What Normal Grief Looks Like in Midlife and Later Life
Grief is one of the most universal human experiences, and one of the least understood. Most of us receive almost no preparation for it. We grow up in a culture that tends to treat grief as something to move through quickly — a problem to solve, a stage to complete, a feeling to manage until we are back to normal. Then loss arrives, and nothing about it feels quick, or staged, or manageable in the way we expected.
In midlife and later life, grief takes on particular weight. By the time we are in our forties, fifties, sixties, and beyond, most of us have accumulated losses — a parent, perhaps a partner or sibling, close friends, sometimes a child. We may be facing the loss of a role we held for decades, a relationship that defined us, or a version of ourselves that illness or circumstance has quietly dismantled. Grief in midlife and later life is often layered, cumulative, and deeply entangled with questions of identity, meaning, and what comes next.
This article explains what normal grief looks like, how it differs from depression and other conditions it is often confused with, what the research says about when grief warrants professional support, and what evidence-based approaches can help when grief becomes stuck.
What is grief, and what does it actually look like?
Grief is the natural response to loss. It is not a disorder, a weakness, or a sign that something is wrong with you. It is the emotional, physical, cognitive, and behavioural response to losing someone or something that mattered — and the evidence is clear that the intensity of grief is broadly proportionate to the significance of the attachment (Stroebe & Schut, 1999; American Psychiatric Association, 2022).
Grief does not follow a neat sequence of stages. The popular Kübler-Ross model — denial, anger, bargaining, depression, acceptance — was never intended as a universal road map for bereavement, and decades of research have found that grief is considerably more variable, nonlinear, and individual than a five-stage model implies (American Psychiatric Association, 2022). People grieve differently, and there is no correct way to do it.
What grief commonly involves — across cultures, life stages, and types of loss — includes:
Intense sadness, longing, and yearning for the person who has died
Waves of emotion that come and go, sometimes without warning
Difficulty concentrating, remembering things, or making decisions
Sleep disruption, fatigue, and changes in appetite
Social withdrawal or, conversely, a need to talk about the person constantly
Guilt, regret, or replaying what was said or unsaid
Anger — at the circumstances, at others, sometimes at the person who died
A sense of unreality, or of the world having changed fundamentally
Physical sensations — heaviness in the chest, a hollowness that is hard to describe
These experiences are not signs that grief is pathological. They are signs that you loved someone, and that their absence is real.
How grief shows up differently in midlife and later life
Cumulative loss
One of the defining features of grief in midlife and later life is its cumulative nature. Research examining bereavement across the life course finds that multiple losses across time have measurable health consequences — and that the accumulated burden of repeated bereavement is different, and in many ways more complex, than a single loss in isolation (Donnelly, 2019). By later life, many people are not simply grieving one death — they are grieving the gradual loss of a generation, the dismantling of a world that was built around particular people and relationships (Fang & Carr, 2022).
This cumulative grief is rarely acknowledged adequately by the people around a grieving person. There is an assumption that older adults are somehow more accustomed to loss, or that grief softens with repetition. Research on bereavement in later life challenges this assumption directly, finding that grief in later life often involves deeper existential distress than at earlier life stages — including the loss of the wholeness of one's own sense of self alongside the loss of others (Fang & Carr, 2022).
Loss and identity
Grief in midlife and later life is frequently also an identity crisis. When the person who has died was central to how you understood yourself — as a partner, a parent, a child, a colleague — their absence does not only leave an emotional void. It disrupts the relational structure through which identity is organised and daily life is experienced (Neimeyer, 2019).
A partner who has been part of your life for thirty years is not simply someone you miss. They are someone who knew you across decades, who held shared memories, who shaped how you saw yourself. The loss of that relationship is also, in part, a loss of the version of yourself that existed within it. Research on meaning reconstruction in bereavement identifies this identity disruption as one of the central challenges of adult grief — and one of the primary areas where grief can become stuck when the work of rebuilding a coherent sense of self is not supported (Neimeyer, 2019; Rolbiecki et al., 2025).
Anticipatory grief and dementia
For many people in midlife and later life, significant grief begins long before a death. Caring for a partner or parent with dementia, chronic illness, or a progressive condition involves a form of loss that is real and accumulating — watching someone change, lose capacities, and gradually become less recognisable — while the person is still physically present. This is sometimes called anticipatory grief, and it can be among the most disorientating forms of loss precisely because it lacks the social recognition and ritual that surround death (Fang & Carr, 2022).
Our library article on caring for a family member explores this experience in more depth, including the research on ambiguous loss and how psychological support can help family carers navigate it.
The dual process model: how grief actually works
The most current and empirically supported framework for understanding how people cope with bereavement is the Dual Process Model, developed by Stroebe and Schut (1999) and subsequently supported by decades of research including a 2024 participatory study that examined the model through lived experience (Larsen et al., 2024).
The model proposes that adaptive grief involves oscillating between two types of engagement. Loss-oriented coping means turning toward the loss itself — feeling the grief, processing the memories, sitting with the pain, mourning. Restoration-oriented coping means turning toward life — attending to the practical demands of a changed life, developing new roles and relationships, finding moments of relief or even enjoyment
Critically, the model holds that both are necessary, and that healthy grieving involves moving between them rather than staying fixed in either. People who remain locked in loss-oriented coping can become overwhelmed and stuck. People who remain locked in restoration-oriented coping — staying busy, not allowing themselves to grieve — may find that the loss resurfaces later and with greater force.
The 2024 lived-experience study found that this oscillation carries learning properties — what people discover on one side of the process informs and supports them on the other (Larsen et al., 2024). This is a kinder model of grief than the one most of us absorbed from culture. It suggests that taking a break from grief — having a good evening, enjoying a meal, laughing at something — is not a betrayal of the person who died. It is a necessary part of how healing works.
What is normal grief, and what warrants professional support?
Most people, given time and adequate social support, adapt to bereavement without requiring professional intervention. Research suggests that the intensity of grief symptoms tends to decline across the first six to twelve months following loss, and that for the majority of bereaved adults, this happens naturally, without specialised treatment (Bonanno & Malgaroli, 2020; Larsen et al., 2024).
This is important to hold onto. Grief does not need to be fixed. It is not a clinical problem. The goal of support — informal or professional — is not to eliminate grief but to ensure that the person grieving is not carrying it entirely alone, and that it does not become something more entrenched than the loss itself warrants.
What is generally within the range of normal grief
Intense sadness, yearning, and longing that persist for months
Grief that comes in waves — better for a time, then worse again
Difficulty concentrating, fatigue, and changes in sleep and appetite
Crying unexpectedly, or being unable to cry at all
Guilt or regret about things said or unsaid
Anger at the circumstances, at others, or at the person who died
Finding reminders of the person everywhere, and wanting to talk about them
Feeling reluctant to clear their belongings or change things in the house
Having moments of forgetting the person has died, then remembering again
Grief that feels particularly acute around anniversaries, birthdays, and milestones
When grief warrants professional support
Prolonged Grief Disorder (PGD) is a clinical diagnosis added to the DSM-5-TR in March 2022, and to the ICD-11 (American Psychiatric Association, 2022). It is characterised by grief that is persistent, intense, and significantly impairing — occurring frequently, for at least twelve months following the loss, with symptoms including intense longing for the deceased, difficulty accepting the death, emotional numbness, a sense that life is meaningless without the person, and identity disruption (American Psychiatric Association, 2022).
PGD is estimated to affect approximately 4–10% of bereaved adults in the general population (Prigerson et al., 2021; Doering et al., 2022). It is not simply grief that lasts a long time — most grief does. It is grief that remains at a level of intensity that prevents engagement with daily life and the gradual rebuilding of a meaningful existence without the person who has died.
Signs that grief may warrant a conversation with your GP or a clinical psychologist include:
Grief that has not shifted in intensity after six to twelve months
Persistent inability to accept that the person has died
Avoiding all reminders of the person, or being unable to engage with anything other than reminders
A sense that life has no meaning or purpose without the deceased
Difficulty functioning at work, in relationships, or in daily life
Persistent thoughts that you should have died alongside the person, or thoughts of self-harm
Grief that you are managing with alcohol or other substances
Depression or anxiety that has developed or significantly worsened since the loss
Grief can also be complicated by the circumstances of the death — sudden or unexpected loss, loss by suicide, violent or traumatic death, or the death of a child — all of which are associated with higher rates of PGD and trauma-related symptoms (Lenferink & Boelen, 2023; Doering et al., 2022).
If any of these apply to you, it is worth speaking to your GP and asking for a referral to a clinical psychologist. You can also book directly at Upside Stories without a GP referral.
What helps: the evidence on grief support
Social connection and not grieving alone
The research on bereavement is clear that social support is one of the most significant protective factors against prolonged grief (American Psychiatric Association, 2022). Grief is not meant to be carried alone. Bereavement support groups — whether community-based or online — can provide a source of connection and reduce the isolation that increases the risk of grief becoming stuck (Rodriguez-Villar et al., 2024). Talking about the person who has died, rather than avoiding the topic, is generally associated with healthier grief outcomes.
Meaning reconstruction
Psychologist Robert Neimeyer's work on meaning reconstruction in bereavement identifies the process of rebuilding a coherent sense of meaning and identity following loss as central to adaptive grief (Neimeyer, 2019). This is not about finding a silver lining, or concluding that the death was somehow for the best. It is about the slower, more honest work of integrating the loss into the story of your life — understanding how the person shaped you, what they gave you that you carry forward, and who you are now in their absence.
Research consistently finds that bereaved individuals who are able to make sense of the loss and reconstruct a coherent narrative — including through storytelling, symbolic acts, and legacy work — report better adjustment than those who remain unable to find any meaning in the experience (Rolbiecki et al., 2025; Barboza et al., 2022).
Continuing bonds
Contemporary bereavement research challenges the older assumption that healthy grief requires "letting go" or achieving closure. Continuing bonds theory, developed by Klass, Silverman, and Nickman, proposes instead that maintaining an ongoing internal relationship with the person who has died can be an adaptive and meaningful part of grief (Klass et al., 1996). Research on the impact of continuing bonds finds that they are a common and often adaptive feature of bereavement — including keeping photographs, speaking to the deceased, engaging in activities they would have enjoyed, and honoring their values in how one lives (Field & Filanosky, 2023).
The key finding is nuanced: continuing bonds are adaptive when they sit alongside the capacity to make meaning of the loss and to rebuild a life. They become complicated when they are combined with an inability to make any sense of the death or to integrate it into one's ongoing story (Neimeyer et al., 2006).
Psychological therapy for grief
For most bereaved adults, professional grief therapy is not required. For those who develop Prolonged Grief Disorder, or whose grief is significantly complicated by trauma, depression, anxiety, or other factors, evidence-based psychological treatment is effective.
Cognitive-Behavioural Therapy (CBT) is the most extensively researched treatment approach for PGD, with a systematic review and meta-analysis of 30 randomised controlled trials finding a statistically significant medium effect on PGD symptoms at post-intervention and a large effect at follow-up (Komischke-Konnerup et al., 2024). Prolonged Grief Therapy, developed by Shear and colleagues, combines elements of CBT and interpersonal therapy with grief-specific components including revisiting the loss story and working toward goals in a life that has meaning without the deceased (Szuhany et al., 2021).
Research from UNSW Sydney published in JAMA Psychiatry found that both CBT and mindfulness-based approaches are effective for PGD, with CBT showing slightly stronger outcomes (UNSW, 2024). For grief complicated by trauma — such as sudden or violent death, or loss by suicide — approaches that also address trauma-related symptoms are particularly relevant.
A clinical psychologist can help you determine which approach is most suited to your situation, and whether your grief falls within the range of normal adaptation or warrants more structured support.
Posttraumatic growth and the unexpected gifts of grief
Grief research has increasingly attended to a phenomenon that many bereaved people report but that our culture rarely validates: the possibility of genuine growth through loss. Posttraumatic growth — the experience of positive psychological change that can emerge from the struggle with profoundly challenging life events — has been documented in bereaved adults across a range of loss types, and includes changes in personal strength, relationships with others, new possibilities, appreciation for life, and spiritual or existential depth (Tedeschi & Calhoun, 2004; Duran, 2024).
Growth does not mean the loss was not devastating, or that one would choose it. It does not mean the grief is over. It means that people are capable of finding unexpected meaning, perspective, and depth in the aftermath of loss — and that this possibility is worth holding onto, particularly when grief feels most consuming.
Research on bereavement in later life finds that many older adults approach loss with a quality of acceptance and existential perspective that is genuinely different from earlier life stages — not because they care less, but because they have lived long enough to understand loss as part of life, and to hold grief alongside gratitude for what was (Fang & Carr, 2022). That is not resignation. It is a form of wisdom that grief, over time, can build.
Frequently asked questions
How long does grief last? When will I feel better?
There is no correct timeline for grief, and no point at which it should be finished. Research suggests that the acute intensity of grief typically begins to ease across the first six to twelve months, but grief rarely disappears — it changes shape, becomes less consuming, and integrates into life differently over time. Many bereaved people describe grief not as something that ends, but as something that becomes more bearable and more woven into a life that still has meaning (Bonanno & Malgaroli, 2020). If your grief has not shifted in intensity after twelve months, or is significantly impairing your daily functioning, it is worth speaking to a psychologist.
Is it normal to feel angry when someone dies?
Yes. Anger is a common and entirely normal part of grief — directed at the circumstances, the illness, the healthcare system, other people, or the person who died for leaving. It is sometimes the emotion that people feel most ashamed of in grief, and the one most in need of acknowledgement. Anger in grief often sits alongside love, and working with it rather than suppressing it is generally healthier. If anger is dominating your experience of grief and impairing your relationships or daily life, a psychologist can help you work with it.
What is the difference between grief and depression?
Grief and depression share many features — sadness, fatigue, difficulty concentrating, social withdrawal, sleep and appetite changes. The key distinguishing features are that grief is typically more fluctuating (waves of intensity rather than constant low mood), more specifically focused on the loss, and more likely to include positive emotions alongside the painful ones — such as gratitude, warmth when remembering the person, or brief moments of relief (American Psychiatric Association, 2022). Depression tends to involve a more pervasive and consistent low mood, more pronounced feelings of worthlessness, and difficulty experiencing positive emotions at all. Both can coexist, and both are treatable. A GP or clinical psychologist can help clarify which is present and what is most useful.
Is it normal to still feel grief years after a loss?
Yes. Grief does not have an expiry date. Many bereaved people carry grief for a deceased partner, parent, sibling, or child across decades — and this is not pathological. The question is not whether grief is still present, but whether it is preventing you from living a full and meaningful life. Grief that remains painful but sits alongside a functioning, connected, purposeful life is within the range of normal human experience (Fang & Carr, 2022).
Do I need a GP referral to see a psychologist at Upside Stories?
No referral is needed to book. Medicare rebates do apply if you have a GP referral with a Mental Health Treatment Plan, which reduces the cost of sessions significantly. A free 20-minute consultation is available for new clients to explore whether Upside Stories is the right fit.
What the research tells us
Most bereaved adults adapt to loss over time without specialised professional intervention; grief intensity typically begins to ease across the first six to twelve months (Bonanno & Malgaroli, 2020; Larsen et al., 2024).
Prolonged Grief Disorder affects approximately 4–10% of bereaved adults and is characterised by persistent, intense, impairing grief that prevents daily functioning for at least twelve months following loss (Prigerson et al., 2021; American Psychiatric Association, 2022).
Grief in later life frequently involves cumulative loss and existential distress — including loss of one's own sense of self alongside the loss of others — and is not softened simply by familiarity with loss (Fang & Carr, 2022).
The Dual Process Model of bereavement proposes that adaptive grief involves oscillating between loss-oriented and restoration-oriented coping — and that both are necessary; taking breaks from grief is not a betrayal but a part of healing (Stroebe & Schut, 1999; Larsen et al., 2024).
Meaning reconstruction — rebuilding a coherent narrative of identity and life following loss — is central to adaptive bereavement, and is supported by storytelling, symbolic acts, and legacy work (Neimeyer, 2019; Rolbiecki et al., 2025).
Continuing bonds with the deceased are a common and often adaptive feature of grief; maintaining an ongoing internal relationship with the person who has died does not prevent healing (Field & Filanosky, 2023; Klass et al., 1996).
CBT is the most extensively evidenced psychological treatment for Prolonged Grief Disorder, with medium-to-large effect sizes in randomised controlled trials (Komischke-Konnerup et al., 2024).
Posttraumatic growth — positive psychological change emerging from the struggle with loss — is well-documented in bereaved adults, including in later life (Tedeschi & Calhoun, 2004; Duran, 2024).
You are not meant to grieve alone
At Upside Stories, Bruce works with people in midlife and later life who are navigating grief, whether it is recent and acute or long-standing and complex (encompassing ambiguous loss, unacknowledged loss, anticipatory grief, complicated by the circumstances of the death, or entangled with identity questions about who they are now that the person is gone). This work draws on evidence-based approaches to bereavement, loss and grief, and a relaxed approach focused on meaning-making, without rushing, fixing, or moving on before you’re ready.
To explore your next chapter, book a free 20-minute consult, today.
References & reading
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